The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1885-1921, 1887-03-08
ANTISEPTIC SURGERY.
PROGRESS MADE IN THE ART
WITHIN 4 FEW YEARS.

Improved Methods of Surgery Which
Produce Astounding Resuits-HealinG
of Wounds by First Intention"-Ne-
cess'tysof Cleanliness-DrssSins'
FIN years ago, on the minutes Of the
PENNSYLVANIA hospital in this city, especial
Mention was made of the fact that an
finger had healed by ''1rst
intention" that is, without the process
of suppuration and granulation, which Is
the usual mode by which tissues neal.
At the present time 1t IS usual ana noG
unusual. to have an amputated leg neal
nv the "frst intention as well as the
wounds made in the performance OF
nearly all major and minor operations Oh
surgery.
So rand has been the progress in the
improved methods of what IS known as
antiseptic surgery that many meCll n;aL
men are astOunded to hear OF the fesCIC1
that are being obtained, and the genera
Dublic are not at all aware OF the = GO
advances in the surgical art. IlIt0C, -,
4icar+ic surgery has been in It's LII III 80,
fo, less than a dozen years, ana H.
received its perfect aPpLiC''''
few months. .l,l,ra exists a reDar-
In the h'tiIl'li - -b fhe separated frag-
alFe Po" - 1,,,oIl,an bone are united and the
menus " q" - =, wound are united. The
CUT SUI Ia, '-C,Ie of bcaiing an open wound
sILiPi+I - ..frst intention or immediate
Is ~ ,, for which surgeons have aimed
o'lli0I IlI,,ndreds of years. They had OBJ
Ior it in rare instances, and looked
mon it as possibility; but, as previously
stated, they seldom succeeded in getting
it, and the instances in which they did
get 1t were deserving of special note. If
union fails by the first intention in
hammatiOn supervenes, and healing is &C
complished by long and tedious process
of suppuratiOn and granulation, requiring
several weeks or perhaps months for the
closure Of wound of any considerable
size. And this is always connected with
u great drain on the vital forces, and dan
ger from blood poisoning.
THE MODERN METHOD.
What is antiseptic surgery? 1t con-
sists of certain precautions and appli-
ances for the exclusion of the air, and
with the air of the numerous germs of
disease and putrefactiOn which float in
it, and the application of a germicide,
which destroys the vitality of these germs
during and after operation. The more
perfectly this is done the more likely will
there be procured the primary union, or
union by ''first intention - Everybody
knows that cut of finger, if promptly
tied up and kept at rest, viii heal readily;
but if it be neglected and allowed to get
particles Of dirt and the germs of disease |
into it there is considerable Inflammation, !
the injured member becomes painful and |
swollen, discharges matter and is slow to |
heal. Antisephc surgery aims at the SIM |
plicity Of domestic practice-the accurate |
cOaptatiOn of the parts, provision being |
made for the free discharge of secretions |
from the wound and the seclusion of the |
air and germs of disease. By the adoption |
of antiseptic measures the surgeon simply |
follows natures indication. He puts the !
parts in the best possible condition to heal |
and nature does the healing.
The methods adopted in order to secure
this success are simple, and but little
more expensive, considering the first cost,
but infinitely less costly than the old way
Of dressing, when consideration is made
for the time and waste of repeated dress
ngs, and the lessened risk of blood poison
ing and death from exhaustion from pro-
Onged sUppuration.
CLEANLINESS ESSENTIAL.
The most essential element in antiseptic
surgery is cleanliness. The part to be
operated upon, or the point of injury and
adjacent tissue, is first thoroughly
crubbed with soap and fine brush. 1t
s then shaved to remove hair and dead
utaneOuS cells, and afterwards washed
With ether, to remove fat and oily matter.
d1lUiSGDIlC
ion, and the operation is begun. A small
tream of the solution is played upon the
arts at short intervals as the operation
progresses. Every opening in the tissues
washed out with this solution. The parts
re brought together with catgut sutures,
which have been rendered aseptic, and
hese sUtureS are absorbed; consequently,
here is nothing to come away. Catgnt, !
,eing an animal tissue, is capable of alb
OrptiOn, and is used for ligaturing vessels,
ewing up the parts, and for drainage
EOr this purpose several strands are pie ced
n the deeper part of a wound and drain
" capillarity. After there are no further
ecretions these are absorbed.
After the superficial opening has been
lOsed and the edges brought into close
opposition, a strip of ''protective'' is laid
Dver the line of sutures. Over this is spread
fold of several thicknesses of gauze, an
prepared, and busted thickly
n its surface with iodoforIn. Over this is
'laced cotton, also rendered antiseplic. o~a
he whole dressing is confined in place r
oller baHdages. This dressing
Yet-au wet, and almost 1-zS-
he antiseptic solution. The DRESSING IS
Ot changed, unless there is some sign tLa5
II is not doing well, until a proper time
as elapsed and it is known that the parts
ave healed. Under these methods hos
ital gangrene and erysipelas are very
lrely encountered, and there is so little
ischarge of pus that recently it was i'm
ossible to get enough for a sample for
Exhibition to q class at a medical college.
This method, with slight changes in the
etail, is now employed at every good hos
ital in the country and by every surgeon
no is up with the times.-Philadelph